[Impact of advanced maternal age on fecundity and women's and children's health].
OBJECTIVE
There has been a consistent trend towards delayed childbearing in most Western countries. We present a review of the current epidemiological understanding of the effects of advanced maternal age on fecundity, maternal and child health.


METHODS
A narrative review of the literature based mostly on the key population-based studies on the subject.


RESULTS
Delayed childbearing results in a substantial decrease in fecundity and a considerable increase in fetal loss; risk of the latter is doubled between 20-24 and 40-44 years of age. Other risks include those related to maternal health (maternal mortality and morbidity) and adverse pregnancy outcomes (multiple births, preterm delivery, fetal growth retardation and congenital anomalies).


CONCLUSIONS
Risks associated with delayed childbearing become significant for maternal age greater than 35 years, and are particularly high for women aged 40 years and greater. Knowledge about the risks associated with advancing age can be helpful for couples in their decisions regarding childbearing.
Khoshnood
B
B
Inserm, UMR S149, IFR69, recherches épidémiologiques sur la santé périnatale et la santé des femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France. babak.khoshnood@inserm.fr
Bouvier-Colle
M-H
MH
Leridon
H
H
Blondel
B
B
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult